润肤剂、类固醇联合卡泊三醇治疗银屑病的效果

Efficacy of Emollients,Steroids and Carbotriol in the Treatment of Psoriasis

目的探讨润肤剂、类固醇联合卡泊三醇联合治疗银屑病的效果。方法选取2020年6月至2022年8月郑州颐和医院诊治的81例银屑病患者作为研究对象,按照随机数字表法分为A组(接受皮质类固醇激素治疗)、B组(接受润肤剂联合类固醇治疗)、C组(接受润肤剂、皮质类固醇激素联合卡泊三醇),各27例。对比3组治疗总有效率、银屑病面积与严重程度指数量表(PASI)评分、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)和白细胞介素(IL)-17、IL-22、IL-23水平。结果C组的总有效率高于B组、A组(P<0.05)。3组PASI评分的时间、组间效应有统计学意义(P<0.05),交互效应无统计学意义(P>0.05)。PASI评分随治疗时间增长而下降,并且两相邻时间点的下降差异有统计学意义(P<0.05);C组治疗4、12周PASI评分均低于B组与A组(P<0.05)。3组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)的时间、组间、交互效应有统计学意义(P<0.05);CD4^(+)、CD4^(+)/CD8^(+)随治疗时间增长而上升,CD8^(+)随治疗时间增长而下降,并且两相邻时间点的下降差异有统计学意义(P<0.05);C组治疗4、12周的CD4^(+)、CD4^(+)/CD8^(+)高于B组与A组,而CD8^(+)均低于B组与A组(P<0.05)。治疗前,3组的IL-17、IL-22、IL-23差异无统计学意义(P>0.05);治疗12周后,C组的IL-17、IL-22、IL-23均低于B组与A组(P<0.05)。结论润肤剂、皮质类固醇激素联合卡泊三醇治疗银屑病效果确切,可减轻皮损面积,调整机体免疫。

Objective To explore the effect of emollients,steroids combined with carbotriol on psoriasis.Methods Eighty-one patients with psoriasis treated in Zhengzhou Yihe Hospital from June 2020 to August 2022 were randomly divided into group A(received corticosteroid therapy),group B(received emollient combined with steroid therapy)and group C(received emollient,corticosteroid combined with carbotriol),with 27 cases in each group.The total effective rate,psoriasis area and severity refers to the quantity table(PASI)score,CD4^(+),CD8^(+),CD4^(+)/CD8^(+),interleukin(IL)-17,IL-22 and IL-23 were compared.Results The total effective rate of group C was higher than that of group B and group A(P<0.05).The time and inter-group effect of PASI score in the three groups were statistically significant(P<0.05),but the interaction effect was not statistically significant(P>0.05).The PASI score decreased with the increase of treatment time,and the difference between two adjacent time points was statistically significant(P<0.05).The PASI score of group C was lower than that of group B and group A after 4 and 12 weeks of treatment(P<0.05).The time,inter-group and interaction effects of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the three groups were statistically significant(P<0.05).CD4^(+)and CD4^(+)/CD8^(+)increased with the increase of treatment time,while CD8^(+)decreased with the increase of treatment time,and the difference between two adjacent time points was statistically significant(P<0.05).CD4^(+)and CD4^(+)/CD8^(+)in group C were higher than those in group B and group A after 4 and 12 weeks of treatment,while CD8^(+)was lower than those in group B and group A(P<0.05).Before treatment,there was no statistically significant difference in IL-17,IL-22 and IL-23 among the three groups(P>0.05).After 12 weeks of treatment,the levels of IL-17,IL-22 and IL-23 in group C were lower than those in group B and group A(P<0.05).Conclusion The combination of emollients,corticosteroids and calcipotriol is effective in treating psoriasis,which can reduce the area of skin lesions and adjust the immunity.